异体脱细胞真皮基质复合自体刃厚皮片移植在面颈部烧伤后期瘢痕挛缩整形中的应用效果  

Application of allogeneic acellular dermal matrix combined with autologous split-thickness skin grafting in plastic surgery for post-burn scar contracture of face and neck

作　　者：王栋 王政刚 丁金艳 毛宇峰 李小龙 张龙杰 桑晨 WANG Dong;WANG Zhenggang;DING Jinyan;MAO Yufeng;LI Xiaolong;ZHANG Longjie;SANG Chen(Department of Burn and Plastic Surgery,Zhucheng People's Hospital,Weifang,Shandong,262200,China)

机构地区：[1]诸城市人民医院烧伤整形科,山东潍坊262200

出　　处：《当代医学》2024年第7期32-35,共4页Contemporary Medicine

基　　金：潍坊市卫生健康委员会科研项目(WFWSJK-2021-017)。

摘　　要：目的分析异体脱细胞真皮基质(ADM)复合自体刃厚皮片移植在面颈部烧伤后期瘢痕挛缩整形中的应用效果。方法选取2018年1月至2022年4月诸城市人民医院收治的45例面颈部烧伤后期瘢痕挛缩患者作为研究对象,按照整形修复方案分为对照组(n=22)与观察组(n=23),两组均切除面颈部瘢痕组织并松解挛缩,对照组接受自体中厚皮片移植,观察组接受ADM复合自体刃厚皮片移植。比较两组皮片成活率、二次手术率、创面感染率、植皮区及供皮区愈合时间、创面修复效果、颏颈角及颈部主动活动度的矫正度数。结果观察组皮片成活率高于对照组,差异有统计学意义(P<0.05);两组二次手术率、创面感染率比较差异均无统计学意义。两组植皮区愈合时间比较差异无统计学意义;观察组供皮区愈合时间短于对照组,差异有统计学意义(P<0.05)。术后6个月,两组皮肤柔软度、厚度、色泽、血管分布评分均低于术后3个月,差异有统计学意义(P<0.05);两组术后3、6个月皮肤柔软度、厚度、色泽、血管分布评分比较差异无统计学意义。两组术后6个月颏颈角及颈部主动活动度的矫正度数比较差异均无统计学意义。结论面颈部烧伤后期瘢痕挛缩整形中应用ADM复合自体刃厚皮片移植的整形修复效果与自体中厚皮片移植相近,然而复合移植的皮片成活率更高,供皮区愈合时间更短。Objective To analyze the application effect of allogeneic acellular dermal matrix(ADM)combined with autologous split-thickness skin grafting in plastic surgery for post-burn scar contracture of face and neck.Methods A total of 45 patients with post-burn scar contracture of face and neck who were treated in Zhucheng People's Hospital from January 2018 to April 2022 were selected as the research subjects,and they were di-vided into the control group(n=22)and the observation group(n=23)according to the plastic repair plan.Both groups underwent face and neck scar tissue excision and contracture release,the control group received autologous medium-thickness skin grafting,and the observation group received ADM combined with autologous split-thickness skingrafting.The skin survival rate,secondary operation rate,wound infection rate,healing time of skin graft area and skin donor area,the effect of wound repair,and the correction degree of chin neck angle and active neck motion were compared between the two groups.Results The survival rate of skin grafting in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05);there was no statistical significance in the secondary operation rate and wound infection rate between the two groups.There was no significant difference in the healing time of skin graft area between the two groups,the healing time of skin donor area in the observation group was significantly shorter than that in the control group,and the difference was statistically significant(P<0.05).6 months after surgery,the skin softness,thickness,color,and blood vessel distribution score of the two groups were lower than those 3 months after surgery,and the differences were statistically significant(P<0.05);there were no significant difference in skin softness,thickness,color,and blood vessel distribution score between the two groups 3 and 6 months after surgery.There was no significant difference in the correction degree of chin neck angle an

关 键 词：异体脱细胞真皮基质 自体刃厚皮片 复合移植 面颈部烧伤 瘢痕挛缩 

分 类 号：R644[医药卫生—外科学]